January 18th, 2011
A common childhood disease
Chicken pox (or varicella) is a common, highly contagious viral disease most likely to occur in children ages 2 to 10. For adults it’s relatively uncommon but can create serious complications when contracted, especially for pregnant women and their unborn children.
Chicken pox is contagious for about a week, from 24 to 36 hours before the rash appears until all the pox sores are scabbed over. Upon exposure, it takes an average of 14 to 16 days for symptoms to develop. Having chicken pox once usually gives lifelong immunity against the disease.
After you’ve had chicken pox, the virus takes up residence in a bundle of sensory nerve cells connected to the spinal cord. For most people the virus remains dormant. However, in some cases the virus is reactivated and travels down the nerve infecting the surrounding skin with a rash that turns into blisters. This is called shingles. No one knows for sure what reactivates the virus, but stress, trauma and certain illnesses can be triggers. Shingles usually occurs on one side of the body (most often on the torso) and is accompanied by sharp nerve pain. Acyclovir (Zovirax) is often prescribed to lessen symptoms.
If you have shingles, it is possible to pass chicken pox on to someone who has never had the disease, although the virus is not often spread this way.
Note the symptoms
Early signs include a vague feeling of discomfort, mild headache, a cough and a low-grade fever. The rash appears as red bumps with tiny fluid-
filled blisters. The blisters crust over within six to eight hours. For five or six days, the rash will appear on various sites of the body, and can include the mucous membranes of the eyes, mouth and vagina. The rash is extremely itchy and can cause permanent scars (slight, round depressions in the skin), especially if the scabs are scratched off. The scabs are present even after chicken pox is no longer contagious. Usually people start to feel better before they look better.
Chicken pox is usually mild in healthy children, but can be more serious in adults or those with immune-system disorders.
Complications from chicken pox include an infected pox, pneumonia and, on rare occasions, encephalitis (an inflammation of the brain), or necrotizing fasciitis (a serious bacterial infection of connective tissue).
Chicken pox is very serious in newborns. If a mother has chicken pox four days or less before delivery, there is a 20% chance that the infant will be born with the disease. This is fatal for the infant in up to 30% of the cases.
A vaccine called Varivax (and referred to as the VZV vaccination) has been approved for use in the U.S. The American Academy of Pediatrics recommends including VZV as part of a child’s immunization program. The recommended dosage is:
One dose given to infants between the age of 12-18 months, and to any child up to age 13 who has not been immunized and who has not had chickenpox.
Two doses given four to eight weeks apart, to children over age 13 and adults who have not been immunized and who have not had chickenpox.
Immunity from the chicken pox vaccine is expected to last about nine years.
What you can do
Treatment for chicken pox is directed toward relieving symptoms and watching for complications. Apply cool, wet compresses. Take an oatmeal bath (one-half to one cup of oatmeal in a tub of lukewarm water). Apply calamine lotion with a cotton swab to the itchy areas, except the mucous membranes (such as the mouth, eyes or vagina). Adults can take an antihistamine, but a pediatrician should be consulted about use in young children. Use mitts on infants and very young children, to avoid scratching.
Acetaminophen (Tylenol) will reduce fever. NEVER give aspirin to children/teenagers. It can cause Reye’s syndrome, a rare but often fatal condition. Children with chicken pox are at increased risk for Reye’s syndrome. If necessary, talk with your doctor about chicken pox over the telephone instead of taking your child into the office. This eliminates the risk of exposing others to the disease.